Abayomi Adeyemi, M.D,S.C

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036084629 Issued in IL

Legal business name

ABAYOMI ADEYEMI, M.D,S.C

Practice address

54910 Apollo CT
La Quinta, CA 92253-8051

Phone

(760) 222-2820

NPI assigned

May 15, 2008

Last updated

Aug 24, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Yomi Adeyemi, M.DNPI 1174523518

Title

Medical Director

Phone

(708) 261-8614

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yomi A Adeyemi, M.D.

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • La Quinta, CA
  • NPI 1174523518
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1902073281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54910 APOLLO CT",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922538051",
            "telephone_number": "760-222-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54910 APOLLO CT",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922538051",
            "telephone_number": "760-222-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABAYOMI ADEYEMI, M.D,S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "ADEYEMI",
        "authorized_official_first_name": "YOMI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-261-8614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036084629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084629",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1918 Winter Street Operating Co LLC (Vons Pharmacy #2175)
• Ethan Abercrombie
• Marianna Abrahamyan
• Rezner H Abubakar
• Yomi A Adeyemi, M.D.
• Behtash Adibi

• Primary Care Clinic/Center in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.